BACKGROUND/OBJECTIVES: Refeeding syndrome (RFS), a life-threatening medical condition, is commonly associated with acute or chronic starvation. While the prevalence of patients at risk of RFS in hospital reportedly ranges from 0 to 80%, the prevalence and types of patients who die as a result of RFS is unknown. We aimed to measure the prevalence rate and examine the case histories of patients who passed away with RFS listed as a cause of death. SUBJECTS/METHODS: Patients were eligible for inclusion provided their death occurred within a Queensland hospital...

BACKGROUND: Dysphagia is a relatively common symptom following laryngectomy. An anterior pharyngeal diverticulum is a rare cause of post-laryngectomy dysphagia. However, it is often an incidental finding on rigid telescopic examination. METHODS AND RESULTS: This article describes two patients with a symptomatic anterior pharyngeal diverticulum. They were treated by transoral micro-endoscopic potassium titanyl phosphate 532 nm laser assisted resection. Both patients could take feeds orally after the procedure without any difficulty...

We are faced with a worldwide opiate/opioid epidemic that is devastating. According to the Centers for Disease Control and Prevention (CDC), at least 127 people, young and old, are dying every day in America due to narcotic overdose. The Food and Drug Administration (FDA) has approved Medication-Assisted Treatments (MATs) for opiate/opioids as well as alcohol and nicotine. The mechanism of action of most MATS favors either blocking of dopaminergic function or a form of Opiate Substitution Therapy (OST). These treatment options are adequate for short-term treatment of the symptoms of addiction and harm reduction but fail long-term to deal with the cause or lead to recovery...

CONTEXT: Dying patients commonly experience potentially distressing symptoms. Palliative care guidelines recommend opioids, anticholinergics, antipsychotics and benzodiazepines for symptom relief. OBJECTIVES: To systematically review the effectiveness and safety of palliative drug treatment in the last days of life of adult patients, focusing on the management of pain, dyspnea, anxiety, restlessness, and death rattle. METHODS: A systematic search of the literature published before December 2016 in PubMed/MEDLINE, Embase, CINAHL, PsycINFO, Cochrane, ClinicalTrials...

PURPOSE: Few reports have focused on the management of congenital tracheal stenosis (CTS) in the neonatal period. The aim of this study was to determine appropriate management strategies for CTS in the neonatal period. METHODS: The medical records of eight neonatal patients with CTS at a single institution between January 2007 and December 2016 were retrospectively reviewed. RESULTS: Three patients with frequent ventilatory insufficiency despite assisted ventilation underwent surgical intervention (balloon tracheoplasty: n = 1, slide tracheoplasty: n = 2)...

INTRODUCTION: Medical assistance in dying (MAID), a term encompassing both euthanasia and assisted suicide, was decriminalised in Canada in 2015. Although Bill C-14 legislated eligibility criteria under which patients could receive MAID, it did not provide guidance regarding the technical aspects of providing an assisted death. Therefore, we propose a scoping review to map the characteristics of the existing medical literature describing the medications, settings, participants and outcomes of MAID, in order to identify knowledge gaps and areas for future research...

OBJECTIVES: Assisted suicide in Switzerland is mainly performed by right-to-die societies. Medical involvement is limited to the prescription of the drug and certification of eligibility. Palliative care has traditionally been perceived as generally opposed to assisted suicide, but little is known about palliative care physicians' involvement in assisted suicide practices. This paper aims to describe their perspectives and involvement in assisted suicide practices. METHODS: A qualitative interview study was conducted with 23 palliative care physicians across Switzerland...

In the United States, physician aid in dying (PAD) is now legal in several states. However, neither a requirement for a palliative care (PC) consultation nor a defined education in PC exists for physicians participating in PAD or patients requesting assistance. Patients with advanced chronic and serious illness often experience complex physical, psychosocial, and spiritual distress. PC focuses on relieving this distress and improving patient quality of life through early identification and intervention in all domains of suffering, including physical, psychological, social, and spiritual...

PURPOSE: Chronic or recurrent pericardial effusion is often associated with malignant disease. However, there have been few reports of the long-term outcomes after video-assisted thoracoscopic (VATS) pericardiectomy. We have performed it since 1992, and report our procedure and outcomes. METHODS: Patients who underwent VATS pericardiectomy were investigated. RESULTS: In all, 29 patients (12 men; median age: 61 (23-88) years) were evaluated; 8 had no malignancies and 21 did...

The use of multidimensional scales for assessing fear of death among nursing students can assist in teaching and evaluating the effectiveness of targeted training in thanatology. Research has demonstrated good psychometric characteristics of the Czech version of the Collett-Lester Fear of Death Scale (CL-FODS). It was applied to nursing students ( N = 256), who reported as their biggest fear the process of their own dying. Greater fear of death and dying was found in students who had no experience of the dying and death of a loved one...

BACKGROUND: Oesophagectomy for corrosive stricture of the oesophagus (CSE) is rarely performed due to high risk of iatrogenic complications. The aims of this study were to review our experience of transhiatal oesophagectomy (THE) in patients with CSE as well as to compare results of open and laparoscopic methods. MATERIALS AND METHODS: This is a retrospective analysis of prospectively maintained data of patients with CSE who underwent open transhiatal oesophagectomy (OTE) or laparoscopic-assisted transhiatal oesophagectomy (LATE) by a single surgical team from 2012 to 2016...

OBJECTIVES: We used GBD 2015 findings to measure the burden of intentional injuries in the Eastern Mediterranean Region (EMR) between 1990 and 2015. METHODS: The Global Burden of Disease (GBD) study defines intentional injuries as a combination of self-harm (including suicide), interpersonal violence, collective violence (war), and legal intervention. We estimated number of deaths, years of life lost (YLLs), years lived with disability (YLDs), and disability-adjusted life years (DALYs) for each type of intentional injuries...

Appropriate and timely on-farm euthanasia is the responsibility of the producer, working together with their herd veterinarian. Unfortunately, validated methods for euthanasia of commercial meat rabbits are lacking and there are few educational materials available for producer training. Because euthanasia must be performed in a timely fashion to minimise suffering, it is critical to ensure that methods used are aesthetic, humane and effective. We surveyed Canadian meat rabbit producers for current on-farm euthanasia practices as well as attitudes towards the methods they employed and thoughts on novel euthanasia techniques...

BACKGROUND AND OBJECTIVE: Cerebral vascular accident (CVA), also known as stroke, is an important health problem worldwide and it affects 16 million people worldwide every year. About 30% of those that have a stroke die and 40% remain with serious physical limitations. However, recovery in the damaged region is possible if treatment is performed immediately. In the case of a stroke, Computed Tomography (CT) is the most appropriate technique to confirm the occurrence and to investigate its extent and severity...

Lynch syndrome describes a familial cancer syndrome comprising germline mutations in one of four DNA mismatch repair genes, MLH1, MSH2, MSH6, and PMS2 and is characterized by colorectal, endometrial, and other epithelial malignancies. Thyroid cancer is not usually considered to be part of the constellation of Lynch syndrome cancers nor have Lynch syndrome tumor gene mutations been reported in thyroid malignancies. This study reports a woman with Lynch syndrome (colonic cancer and a DNA mismatch repair mutation in the MSH2 gene) with a synchronous papillary thyroid cancer...

PURPOSE: Adolescents and young adults (AYA) with cancer are a cohort requiring specialized healthcare models to address unique cognitive and physical challenges. Advance care planning (ACP) discussions likely warrant age-appropriate adaptation, yet, there is little Australian research data available to inform best practice for this group. The goal of this work is to inform future models of ACP discussions for AYA. METHODS: Retrospective medical record audit of AYA patients and an adult comparison group, diagnosed with a malignancy and referred to a community hospice service, in Western Australia, in the period between January 1, 2012 and December 1, 2015...

We describe a patient who died from a fulminant presentation of encephalitis. After an exhaustive search, we found no treatable cause. Postmortem PCR analysis of brain tissue led to a diagnosis of eastern equine encephalitis. We have identified several clinical pearls that may assist others in making the diagnosis earlier in the disease course.

BACKGROUND: Autonomy has become a key organizing principle in the official and expert discourses of the social services focused on strengthening of clients' independence and self-sufficiency. While "caring" has been seen as a threat to the autonomy of an individual, the care dependency and need for palliative care for people with dementia living in residential institutions are growing. METHODS: Participatory action research was realized in 9 homes providing services for people with dementia with the aim to improve the quality of care...